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| Title |
Direct and Indirect Bonding of Orthodontic Brackets Display No Difference in Bond Failure Rate |
| Clinical Question |
In patients undergoing orthodontic treatment, does indirect bonding of orthodontic brackets have lower bond failure rates compared to direct bonding? |
| Clinical Bottom Line |
There was no difference in bond failure rate between direct and indirect bonding of orthodontic brackets. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 18068590 | Deahl/2007 | Patients undergoing orthodontic treatment lasting at least one year, with full fixed appliances on both the upper and lower arches. | Other | | Key results | No difference in bond failure rate was found between direct and indirect bonding of orthodontic brackets (P= 0.225). Samples were collected from 11 orthodontists examining 29,963 brackets in 1,368 patients. 5 orthodontists used direct bonding methods with 772 patients. 6 orthodontists used indirect bonding on 596 patients. | | #2) 16926313 | Thiyagarajah/2006 | Adolescent patients undergoing orthodontic treatment lasting at least one year, with full fixed appliances on both the upper and lower arches. | Randomized Controlled Trial | | Key results | No significant difference in the bond failure rate was found between direct and indirect bonding of orthodontic brackets (P=0.565). 33 patients aged 12-15 were randomly assigned to two different groups for a split mouth study. | |
| Evidence Search |
"indirect" AND "Direct" AND "bonding" AND "Bracket" |
Comments on
The Evidence |
Deahl, et al sampled multiple orthodontists, covering a large sample size of patients. Since there was no oversight in the selection criteria, the exact similarity between patient groups is unknown. There was adequate follow up of the patients. Patient compliance and completion was not an issue since the treatment was at the patients’ expense.
Thiyagarajah, et al used a single blinded randomized split mouth study in order to eliminate the operator error and bias. They had similar groups at the start of the trial. They had a 32 of the 33 initial patients complete the study. There was adequate follow up of the patients. There appears to be no recall bias with the patients.
|
| Applicability |
Both studies conclude that direct and indirect bonding methods display equal bond failure rates in patients receiving orthodontic treatment. Since there are no adverse effects, the only limiting factor is the practitioner’s familiarity with either method. Practitioners using an unfamiliar method should expect to see a higher failure rate initially. This rate should then decrease as they gain more experience with that particular technique. |
| Specialty/Discipline |
(Orthodontics) |
| Keywords |
Orthodontic brackets, direct bonding, indirect bonding
|
| ID# |
2685 |
| Date of submission: |
03/28/2014 |
| E-mail |
mayberryd@livemail.uthscsa.edu |
| Author |
Derick Mayberry |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Clarence C. Bryk, DDS, MS |
| Faculty mentor/Co-author e-mail |
brykc@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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